Browsing by Author "Yadav, Narender"

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    MDCT Findings in Focal Fat Infarction of Appendage of Falciform Ligament- An Unusual Cause of Epigastric Pain.
    (Akshantala Enterprises Private Limited, 2020-02) Gupta, Ranjana; Yadav, Rishabh; Singh, Simar Abheet; Mittal, Puneet; Yadav, Narender
    The pathophysiology and clinical course of focal fat infarction of appendage of falciform ligament is similar to other acute fat infarction abdominal conditions like omental infarction and epiploic appendagitis in that it presents with acute abdominal pain and responds well to conservative treatment. Importance of radiological diagnosis is to avoid unnecessary surgery.[1] Torsion and focal fat infarction of appendage of falciform ligament is an extremely rare condition which presents with acute abdomen. It can mimic other serious abdominal conditions which require urgent surgical intervention. It is important to be aware of its computed tomography (CT) findings so as to avoid unnecessary surgical intervention. We present CT findings in case of focal fat infarction of appendage of falciform ligament in a young male who presented with acute epigastric pain.
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    Megalencephalic Leukoencephalopathy with Subcortical Cysts.
    (Akshantala Enterprises Private Limited, 2020-02) Gupta, Ranjana; Kumar, Akshay; Yadav, Narender; Singh, Simar Abheet; Mittal, Puneet
    Megalencephalic Leukoencephalopathy is a rare entity which was first described by Van Der Knaap et al in 1995.[1] It is a progressive neurodegenerative disorder characterized by slow progression of mental deterioration. Megalencephaly sets in early in the disease usually in first year and can be more than 4 standard deviation above the mean. Seizures are present in almost all the patients. [2] We present typical MRI findings in a case of megalencephalic leukodystrophy with sub-cortical cysts.Megalencephalic leukoencephalopathy with sub-cortical cysts is a rare entity that presents with macrocephaly and seizures. Mental deterioration is often mild with slow progression. Macrocephaly may be present at birth or develops in first year. Typical magnetic resonance imaging (MRI) findings help to clinch the diagnosis.
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    Presacral Ancient Schwannoma in a Middle-Aged Man- A Rare Entity,
    (Akshantala Enterprises Private Limited, 2020-02) Yadav, Narender; Gupta, Ranjana; Singh, Simar Abheet; Mittal, Puneet; Mahendru, Shivani
    Schwannomas are benign tumours arising from neoplastic transformation of Schwann cells around the nerve fibres. Tumours situated deeply like in retroperitoneum or pelvis are usually asymptomatic and may not be detected. Such long standing tumours may undergo extensive degenerative changes giving rise to ancient schwannomas.[1] Ancient schwannoma is an uncommon variant of schwannomas characterized by extensive degenerative changes and hypocellular areas. Presacral ancient schwannomas are rare and most of the reported cases are in females. We describe computed tomography (CT) findings in a case of presacral ancient schwannoma in a 49 year old male patient.
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    Prognostication in Traumatic Brain Injury- A Prospective Study of 100 Patients in Tertiary Care Hospital in Rural Area.
    (Akshantala Enterprises Private Limited, 2020-02) Rohilla, Devanshu; Tyagi, Sandeep; Singh, Sohan; Narula, Harneet; Bansal, Tanu; Yadav, Narender; Garg, Shankey; Jain, Amit
    Traumatic brain injury is a major health issue responsible for considerable mortality and morbidity worldwide especially in subjects under the age of 40 yrs. It is important to assess and grade the TBI as soon as possible to guide management and decrease the comorbidities. Various guidelines have been issued by the neurosurgical societies to immediately assess and intervene when ever required. In this study, we have tried to assess the role of basal cisternal effacement in the management and prognosis of RTA patients, and hence tried to simplify the prognostication process and improve the patient management.METHODS100 subjects were studied who were having history of traumatic head injury. NCCT was done for all the patients using 128 slice Multidetector CT- Ingenuity (Philips Medical Systems, USA). Other parameters like pupillary reaction, GCS at the time of presentation, midline shift and associated fractures and bleed were assessed. All the patients were followed up till the time of discharge. The data so obtained was analysed.RESULTSParameters like age, pupillary reflex, GCS at presentation, associated intracranial bleed, associated cranial vault fractures and presence or absence of midline shift correlated well with the final outcome with p value consistently <0.05. We analysed that the degree of obliteration of perimesencephalic cistern was a good prognostic marker in traumatic head injury patients. 36% of patients had favourable outcome out of which none of the patients had obliterated perimesencephalic cistern or interpeduncular cisterns. 64% patients had unfavourable outcome out of which 60% and 48% had obliterated or partially obliterated perimesencephalic cisterns and interpeduncular cisterns respectively, and only 4% and 16% had normal perimesencephalic cisterns and interpeduncular cisterns respectively.CONCLUSIONSIt is important to investigate, grade and prognosticate traumatic head injury patients at the earliest. Our study and various other studies prove that various clinical predictors including age, Glasgow coma scale, and pupil reactivity correlate with outcome of patient. Presence of midline shift, intraventricular haemorrhage, and obliteration of cisterns in patients of traumatic brain injury also correlate with the outcome and can be used; thus, making the prognostication process much easier. These findings can be used on the first day of admission itself.
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    Ring like Enhancement in Dysembryoplastic Neuroepithelial Tumour (DNET)
    (Akshantala Enterprises Private Limited, 2020-02) Singh, Simar Abheet; Mittal, Puneet; Gupta, Ranjana; Yadav, Narender; Singh, Balkaran
    DNET is a low grade cortical neoplasm which closely resembles cortical dysplasia on magnetic resonance imaging (MRI). It is usually non-enhancing but can show some enhancement on about one third of case. Rarely enhancement can be ring like and when the mass is large in size, it can cause considerable diagnostic problem from higher grade gliomas. However, age of the patient and associated features like calcification, lack of mass effect and long duration of symptoms should assist in reaching the correct diagnosis. Dysembryoplastic neuroepithelial tumour (DNET) is low grade cortical glioma which is most commonly seen in temporal lobe. It is usually a non-enhancing tumour but sometimes it can show enhancement and occasionally it can be ring like, which can cause diagnostic confusion with higher grade gliomas. We report a case of DNET which showed ring like enhancement of post contrast images.
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    Traumatic Mesenteric Tear with Right Adrenal Haematoma and Partial Thrombosis of Inferior Vena Cava- A Rare Association
    (Akshantala Enterprises Private Limited, 2020-01) Yadav, Narender; Gupta, Ranjana; Mittal, Puneet; Pundeer, Sameer; Singh, Simar Abheet
    Post-traumatic isolated mesenteric tear with associated small bowel gangrene is a rare event after blunt abdominal trauma and has been reported previously in literature. [1] Post-traumatic thrombosis of inferior vena cava (IVC) is a very rare event with only isolated case reported in literature. [2] We report a rare case of mesenteric tear with segmental small bowel infarction. There was also right adrenal gland haematoma with associated thrombosis of right adrenal vein, which was extending into inferior vena cava causing its partial thrombosis. Post blunt trauma focal mesenteric tear and segmental small bowel gangrene is a rare event. Posttraumatic right adrenal haematoma is well described in literature while traumatic inferior vena cava (IVC) thrombosis is exceedingly rare. We report a rare case showing association of focal mesenteric tear with segmental small bowel gangrene and associated right adrenal haematoma with adrenal vein haematoma extending into IVC causing its partial thrombosis. To the best of our knowledge, such unusual association has not been reported previously in literature.